A successful relationship between healthcare practitioner and patient depends on mutual trust. In order to establish that trust practitioners must respect the autonomy of their patients. Patients must be given sufficient information in a way that they understand, to enable them to exercise their right to make informed decisions about their care. This is what is meant by informed consent. The right to informed consent flows from the Bill of Rights as enshrined in the South African Constitution, the National Health Act, the Health Professions Act and the HPCSA Ethical Rules and Guidelines. Health practitioners are expected to be aware of law in this regard and the following legislative framework serves as a guideline to practitioners:
1. Section 6(1)(b) & (c) of the National Health Act states that. “Every healthcare provider must inform a user of the range of diagnostic procedures and treatment options generally available to the user; the benefits, risks, costs and consequences associated with each option”.
2. Section 53(1) of the Health Professions Act states that “every person registered under this Act shall, unless circumstances render it impossible for him or her to do so, before rendering any professional services inform the person whom the services are to be rendered or any person responsible for the maintenance of such person, of the fee which he or she intends to charge for such services”.
3. Ethical Rule 27(A)(d) of the Ethical Rules of Conduct for Practitioners Registered Under the Health Professions Act, 1974 states that, “A practitioner shall at all times provide adequate information about the patient’s diagnosis, treatment options and alternatives, costs associated with each such alternative and any other pertinent information to enable the patient to exercise a choice in terms of treatment and informed decision-making pertaining to his or her health and that of others”.
4. According to the National Patients’ Rights Charter (2.8), “Everyone has a right to be given full information about the nature of one’s illness, diagnostic procedures, the proposed treatment and risks associated therewith and the costs involved”.
The HPCSA has been inundated with complaints against practitioners related to the costs of services rendered by practitioners. You are reminded that it is your responsibility to inform patients about the total cost in monetary terms of services, irrespective of what the patient’s medical aid covers or doesn’t cover. Informing patients about the following does not meet the standard of an informed consent as stated above:
“I charge private rates”
“I charge medical aid rates”
“I am contracted in” or “I am contracted out”
“Don’t worry, your medical aid will cover everything”
Healthcare costs can become a massive financial burden for patients, it is important for practitioners to inform their patients of the financial implications of the treatment alternatives just as they inform them about treatment side- effects. For further information practitioners should refer to Booklet 9: Seeking Patient’s Informed Consent – The Ethical Considerations
Last Updated on 18 May 2015 by HPCSA Corporate Affairs